Individual
BRANDI JEAN RICHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 551-6704
Mailing address
27 FIELDPOINT RD, MONTGOMERY, IL 60538-2607
(630) 551-6704
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096005352
IL
Other
Enumeration date
01/25/2019
Last updated
11/16/2024
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